Saturday, December 17, 2016

“In Rwanda, we
were able to establish an equitable health sector by sharing the social capital
equally. More than 90% of Rwandans have health insurance, and more than 93% of
children are vaccinated against 11 antigens. We have universal access to HIV
treatment, and the result of our TB treatment is among the best on earth."

"This was
only possible because we have built our health sector where health is not the
only silo. We have taken other social determinants into account and built a health
sector with the sector in charge of gender, local governance, and education. We
have created a system of multi-stakeholders’ intervention in synergy and
harmony, inside of a multi-sectoral approach.”

Agnes Binagwaho, Professor University of Global Health Equity, explains
how, as Minister of Health in Rwanda from 2011 to 2016, she was able to
contribute to building an equitable health sector in Rwanda.

Saturday, August 27, 2016

Here, I am interviewed by Deutsche Welle, the German Broadcast Service for foreign countries, during the 2016 World Economic Forum, which was held in Kigali. This discussion was around the impact of non-communicable disease on development and the need to create health systems and sustainable partnerships to support the delivery of quality care. I share my perspective on how a multi-sectorial approach and teamwork is essential to reach each patient at the right time.

Tuesday, July 5, 2016

Minister Binagwaho (L) consults with Dr Patrick Ndimubanzi, the State Minister in charge of Public

Health and Primary Health Care, during the news conference in Kigali. (Nadege Imbabazi)

Rwandans have been urged to ensure that their homes and surroundings are kept clean at all times and clear bushes or stagnant water which are breeding grounds for mosquitoes.

Dr Agnes Binagwaho, the Health minister, made the call, yesterday, at a news conference at the ministry headquarters.

A mother and her child sleep under a mosquito net. This is one of the methods to fight against malaria. (File)

She warned that, due to the warm season ahead, malaria cases could shoot up again if caution is not undertaken by homes to supplement government efforts to ensure that no person dies of malaria again.

“In the fight against malaria, we’ve realised that there’s a portion that is still not fully done, and that is the maintenance of sanitation in homes and our environment.

An official from Rwanda Biomedical Center speaks to the media during press conference.

The government can provide bed nets, train community health workers, offer medical insurance but if we ignore the simple things such as cleanliness in our homes and environment, we won’t succeed in the fight against malaria,” she said.

The minister urged the public to seek quick medical attention whenever they fall sick and people without insurance cover to get it.

She added that, in a research conducted two years ago, they found out that people without medical insurance accounted for more than 3 times the deaths resulting from malaria.

“Most people who die from malaria are those without medical insurance because they fear seeking medical care without it. I urge them to get medical insurance because it’s likely that malaria is going to increase. We have trained community health workers to handle cases and they are fully equipped,” she added.

Minister Binagwaho speaks during the press conference in Kigali yesterday.

During the implementation of the malaria contingency plan in highly affected areas, the ministry increased the number of effective long lasting insecticidal nets (LLINS), targeted indoor residual spraying and improved the levels of malaria and behavioural management and inspection of insecticides, drugs and malaria commodities.

The number of houses sprayed stands at 453,320 representing 99 per cent in five out of eight highly affected districts.

Also, 2.6 million LLINS have already been distributed and an additional 6 million will be distributed by the end of this year.

Malaria cases have significantly reduced from 2,456,091 last year to 1,353,861 cases this year.

On the issue of bed nets that were once procured and later found not to be effective, the minister said they now conduct their own testing of bed nets even after the World Health Organisation has done its own testing.

This, she said is to ensure that the bed nets are up to the standards as required by MOH.

“Although government is employing different methods to fight against malaria, what is most important is that we embark on maintaining cleanliness in our houses and communities. Hygiene is very important in this fight,” she said.

For inquiries on the above article, please contact editorial@newtimes.co.rw.

Africa: Govt Closer to Using Drones in Medical Supplies Delivery

Zipline
Inc, a California-based robotics firm Friday announced details of a
partnership with Government to make on-demand deliveries of life-saving
medical products using drones.

This follows a deal
signed in February, between the government and the firm to build
infrastructure for unmanned aerial system (UAS) to ensure efficient
logistical transportation of medical supplies in the country.

Speaking during a
press briefing, the Minister for Youth and ICT, Jean-Philbert
Nsengimana, said that Rwanda is ready to receive the first delivery of
drones.

"We have had a
fruitful and a fun-filled week talking about the forth industrial
revolution at the World Economic Forum (WEF). I think it's very
significant for people to know that what they might think will be
achieved in future, is already here in Rwanda. We already have the
technology that people think we will have in the future. Rwanda is ready
to receive the network of drones, and I truly believe this is going to
shape the future," Nsengimana noted.

According to the
World Health Organisation (WHO), millions of mothers and children die
every year due to conditions that could be prevented or treated with
access to simple, and affordable medical interventions.

However, in the
developing world, access to these interventions is hampered by what is
known as the last-mile problem: the inability to deliver needed medicine
from a city to rural or remote locations due to lack of adequate
transportation, communication and supply chain infrastructure.

The distribution of
blood products is particularly challenging given the strict temperature
requirements and short shelf life. Africa has the highest rate of
maternal deaths in the world, mainly due to post partum hemorrhaging,
which makes access to lifesaving blood transfusions critically important
for women across the continent.

In Rwanda, rural
hospitals have struggled with supplies in the past due to their isolated
locations. Most life-saving supplies are currently delivered via
motorcycles. According to Dr Agnes Binagwaho, the Minister for Health, the initiative is truly a life-saving technology. "We have
established that if we manage to use this technology, it will be a
life-saving initiative. There are a lot of advantages, but I'm also
hopeful that as pioneers we learn by doing. Although, I can't predict
how many lives will be saved, even saving one life is crucial," she
said.

What Zipline is bringing

According to Keller
Rinaudo, Zipline Chief Executive Officer, the company is working with
the government of Rwanda to create a network of delivery drones that
will ferry medical supplierding to the World Health Organisation (WHO),
millions of mothers and children die every year due to conditions that
could be prevented or treated with access to simple, and affordable
medical interventions.

However, in the
developing world, access to these interventions is hampered by what is
known as the last-mile problem: the inability to deliver needed medicine
from a city to rural or remote locations due to lack of adequate
transportation, communication and supply chain infrastructure.

The distribution of
blood products is particularly challenging given the strict temperature
requirements and short shelf life. Africa has the highest rate of
maternal deaths in the world, mainly due to post partum hemorrhaging,
which makes access to lifesaving blood transfusions critically important
for women across the continent.

The network will have capacity to make 50 to 150 deliveries per day,
using a fleet of 15 drones, each with twin electric motors and an almost
eight-foot wingspan. The unmanned drones will use GPS to navigate, and
will airdrop supplies before returning to the landing strip from which
they were launched.

"The inability to
deliver life-saving medicines to the people who need them the most
causes millions of preventable deaths each year. Zipline will help solve
that problem once and for all. We've built an instant delivery system
for the world, allowing medicines and other products to be delivered
on-demand and at a low-cost, anywhere," said Rinaudo.

Starting July, the
government will begin a public-private partnership with Zipline for the
last-mile delivery of all blood products throughout the country. A team
of Rwandan and American engineers will set up and operate Zipline's
first Hub in Muhanga District. From this Hub, Zipline will deliver
life-saving blood to 21 facilities located in the Northern, Western, and
Southern Provinces.

Zipline plans to
expand services to Eastern Province in early 2017, putting almost every
one of Rwanda's 11 million citizens within range of lifesaving medical
product deliveries.

The partnership will strengthen ongoing efforts by the Ministry of Health to deliver a high standard of health care.

First Lady urges action to end neglected tropical diseases

First Lady Jeannette Kagame addresses the meeting on NTDs in Kigali yesterday. (Courtesy)

Africa needs stronger commitment from both public and private sectors
to tackle Neglected Tropical Diseases (NTDs) on the continent, First
Lady Jeannette Kagame has said. Mrs Kagame made the remarks, yesterday, at a World Economic
Forum-sanctioned event convened by the END Fund on ending neglected
tropical diseases on the continent. The event intended to shade more light on the continent’s health
issues, and particularly called for increased investments in NTD control
in sub-Saharan Africa. The event was attended by Her Royal Highness the Queen of Buganda
Kingdom of Uganda, Sylvia Nagginda; the Chief Executive of the END Fund,
Ellen Agler; the Minister for Health, Dr Agnes Binagwaho, among other
officials and health experts.

A study conducted by Erasmus University, and released at the End Fund
event, indicates that Sub-Saharan Africa could save up to $52 billion
by 2030 if the region meets the World Health Organisation’s 2020 control
and eliminations target for the five most common neglected tropical
diseases, such as Elephantiasis, River blindness, Bilharzia, Intestinal
worms and Trachoma.

The study was conducted with support from the Bill and Melinda Gates Foundation.

Mrs Kagame said this kind of events bring more light to some of the
health issues still affecting the region, calling for stronger
partnerships in bringing an end to the NTDs. “In a world fast evolving and creating new solutions to various
health, environmental, socio-economic problems, while connecting people
through technology, it comes as a sad irony that such a large population
of our planet still struggles with diseases that should have been
eradicated a long time ago,” the First Lady said. Figures indicate that 1.6 billion people have had at least one
tropical disease, while 500,000 die each year from complications linked
to the diseases. Mrs Kagame said “the figures of the number of people affected
worldwide each year, by these various tropical diseases are indeed
alarming.”

“I believe that, for our communities to pave the way to a future free
from these health issues, we must continue educating our populations on
how to protect themselves, but also further invest in strengthening
institutions for more efficient health care systems, able to respond
rapidly to this kind of crises,” she said.

Discussing the role of traditional and cultural institutions to end
NTDs, Queen Nagginda said NDTs have been recognised as a health
challenge “yet little attention have been paid to this challenge.”

She said NTDs are mostly found along the Rift Valley side of Uganda
and urged cultural leaders to be part of the campaign to end the
diseases. “Cultural institutions have a role to play in fighting NTDs through
partnering with health institutions to promote healthcare programmes.
Cultural leaders have the ability to mobilise, modernise communities
towards health care and development matters,”

Through her Nnabagereka Foundation, the Queen of Buganda has been
involved in several health advocacy and women empowerment efforts in
Buganda region in central Uganda.

On Rwanda’s case, according to the Ministry of Health, there were no
large scale NTDs control efforts in place and data on the burden of the
diseases until 2007. However, over the last eight years, the Government, with support of
partners such as The End Fund, has taken steps to reduce the burden of
NTDs. Dr Binagwaho said Government has since mapped the prevalence of
intestinal worms, bilharzia, elephantiasis and Trachoma, adding that it
is now “implementing a comprehensive approach to improve hygiene, mass
drug administration, among other NTDS case management campaigns.”

“The Government has tripled the budget to curb NTDs in the last three
years, and it seeks to double the budget in the next two years,” she
said. End Fund’s Agler said NTDs control efforts “offer a return on investment unparalleled in global health.”

“Ending these debilitating diseases will help reduce poverty at all levels,” Agler said.

Mrs Kagame said, over time, Rwanda has seen a decrease in the number
of people affected by these infections and the country now considers
only two of the five NTDs to be a public health problem.

“I trust that such a conversation, will help create a stronger sense
of our shared responsibility in fighting these diseases, while
implementing strategies that can significantly empower our communities
to fully thrive, to live the kind of dignified lives, we all so
rightfully deserve, irrespective of our cultural or economic
backgrounds.”

joined the fight against malaria that is increasingly claiming more people both in the

country and in Africa.

The Military is currently engaging different players in the health
sector to harmonise efforts against the killer disease. The Army is
coming in to utilize its resources which includes, doctors, logistical
muscle and the human resource distributed across the country.

The Ministry of Health is championing the campaign. A symposium was
organised together with the military to define strategies and
interventions that can be implemented at different levels of the health
system.

The head of internal medicine at Rwanda Military Hospital, Lt. Col.
Dr. Jules Kabahizi said at the symposium that the army is keen on
contributing significantly to reduce malaria cases with a long term
objective of eliminating the disease.

Health Minister Dr. Agnes Binagwaho said during a one-day Malaria
symposium at Serena Hotel that, “am glad our army has joined the battle
field. ”

“Malaria is a threat, malaria is a problem, and it’s not only for
Rwanda alone but for the whole region and it is affecting even the
economies,” she said.

According to Binagwaho, Rwanda had pushed malaria to the edge and “we
had started the elimination phase but it’s increased ten times more.”

Statistics from the ministry of health indicate the country has
managed to reduce incidence of malaria by 86%, Mobility by malaria by
87% while mortality was reduced by 74%.

Dr. Binagwaho said that mosquitoes are now able to fly between 4 to
22 kilometers a day and survive to up to a month and are able to fly
higher altitudes. This implies they can now easily fly across borders.

“Now they have leant to fly high because of global warming, it’s no
longer cold up there and in less than a month they can cover the
country,” she noted.

The movement of mosquitoes facilitated by several factors makes it
difficult for one country to lay strategies to eliminate Malaria and
thus suggests joint strategies for regional governments.

Malaria experts said drug-resistant malaria is not spreading across
eastern region, but is developing independently in isolated pockets.

For Dr. Binagwaho with this new knowledge on drug-resistant malaria,
there is need for regional member states to collaborate on a new
strategy for combating the potentially fatal parasite.

Prof Zulu Prenji, chair-pathology in Aga Khan university Hospital told KTPress
that Malaria fight needs political support. He explained that in
countries where there are problems such as corruption, the fight becomes
challenged.

Dr. Olushayo Olu, World Health Organisation Representative in Rwanda
says despite remarkable increase in malaria cases, countries still have
room to eliminate Malaria deaths through early detection and prevention.

Meanwhile, in a rare breakthrough, an international team of
scientists has discovered that a mutation that makes parasites resistant
to a key anti-malarial drug winds up killing them.

“The resistant parasites die before they can infect another person,”
said Christopher D. Goodman of the University of Melbourne, a member of
the research team.

Profile

is a pediatrician who has served 14 years in high-level government positions across the Rwanda Health Sector. She is currently a Senior Lecturer in the Department of Global Health and Social Medicine at Harvard Medical School, a Professor of the Practice of Global Health Delivery at the University of Global Health Equity in Rwanda, and an Adjunct Clinical Professor of Pediatrics at Dartmouth College's Geisel School of Medicine.